Download Chelation Therapy

Chelation Therapy
Jodie Baunsgard
FSCN 547
Summer 2006
Learning Objectives
• What claims are being made about
chelation therapy?
• What is chelation therapy commonly used
for?
• How can chelation therapy be toxic?
• Why is chelation therapy being used to
treat Coronary Artery Disease (CAD)?
• What conclusions were made by the 2000
study made by University of Calgary?
• What is the current TACT study hoping to
achieve in their 5-year study on chelation
therapy?
What is Chelation Therapy?
• Chelation (KEE-LAY-SHUN) comes
from the Greek word – “chele”which means claw.
• “the use of a chelating agent to bind
with a metal in the body to form a
chelate so that the metal loses its
toxic effect or physiological activity”
~Merriam-Webster's Medical
Dictionary
What is Chelation Therapy?
• Chelation therapy is an
investigational form of
complementary or alternative
therapy that uses the man-made
amino acid, called EDTA (ethylene
diamine tetra acetic acid).
• EDTA is administered via an IV.
www.fitchicago.com
Chelation- claw-like
formation
www.mcdonaghmed.com/images/Chelation5.jp
g
Common Uses of Chelation
Therapy
• Chelation therapy has primarily been
used as agent to detoxify heavy metals
such as calcium, iron, magnesium, lead
and zinc.
• EDTA binds to these metal ions because
of its strong affinity for cations.
• The bound metal ions are then excreted
in the urine.
Toxicities Related to
Chelation Therapy
• chelation therapy must be used with
supplementation of calcium
• There have been a few deaths
recorded related to hypocalcemia as
a result of chelation therapy
-stroke- calcium facilitates the
conversion of prothrombin - > thrombin
-heart attacks – calcium helps to
regulate heartbeats
History of Chelation
Therapy
• EDTA the chelation agent developed in
Germany during WWII as a substitute for
citric acid, because supplies were scarce.
• Brought to the US in 1947.
• 1950s-Determined effective especially
with lead detoxification
• 1960- current- toxicologists begin testing
chelation therapy with CAD patients
Claims of Chelation
Therapy
Many claims…very little proof…
• CAD
• Alzheimer’s Disease
• Neurodevelopment diseases related to
toxic metals
• Autism Spectrum Disorder
Chelation Therapy and CAD
• Chelation Therapy and Coronary
Artery Disease is a contemporary
hot topic of much controversy in the
medical realm.
• It is an investigational theory that is
currently being tested to determine if
chelation therapy can be used to
remove plaque from coronary
arteries.
How it possibly works to
decrease CAD
• Atheromatous plaque is one of the
leading causes of CAD.
• A major component of plaque is
calcium.
• 3-Theories of plaque removal:
– EDTA might break up atheromatous plaque.
– EDTA may activate a hormone that sets
calcium free.
– Chelation therapy may reduce oxidative
stress on walls of blood vessels.
Atherosclerotic Artery
www.mcdonaghmed.com
Criteria for Usage of
Chelation Therapy with
CAD
Patients using Chelation therapy must
follow strict criteria:
• CAD must be in a stable state
• Prior to treatment patient must have cardiac
function measured using a electrocardiogram
ECG
• functioning kidney and liver
• Normal blood count
• No cancerous growth and no other infectious
immune compromising diseases
• Need to have a nutrition screen done
• Must continue regular CAD treatment with
physician
The Scientific
Evidence
(3 Studies:
1 Meta-analysis
2 studies)
Shrihari, JS, et al., Role of EDTA chelation
therapy in cardiovascular diseases.
The National Medical Journal of India,
(2006)19.
• Objective: To analyze data retrieved from
various studies to determine the efficacy of
chelation therapy on cardiovascular diseases.
• Study Design: This was a meta-analysis
study of 7 other studies with usage of chelation
therapy
• Subjects: Between 10 and 153 participants
depending on study.
Shrihari, JS, et al., Role of EDTA chelation
therapy in cardiovascular diseases.
The National Medical Journal of India,
(2006)19.
Authors (Year)
Patient profile
Kitchell et al. 196314
CAD
Knudtson et al. 200215
Sample
size
Randomization
Blinding
Results
28
Not described
Double
No benefits
CAD
84
Described
Double
No benefits
Anderson et al. 2003
CAD
53
Described
Double
No benefits
Olszewer et al. 1990
Peripheral AD
10
Not described
Double*
Improvement in walking
Sloth-Nielsen et al.1991
Peripheral VD
153
Described
Double
No benefits
Guldager et al.1992
Peripheral AD
153
Described
Double
No benefits
van Rij et al. 1994
IHD, PV
32
Described
Double
No benefits
Shrihari, JS, et al., Role of EDTA chelation
therapy in cardiovascular diseases.
The National Medical Journal of India,
(2006)19.
• Meta-analysis conclusion:
-EDTA all with vitamins and minerals does
not provide additional benefits in CAD.
-Further research needs to be done in order
to use chelation therapy as a definitive
therapeutic modality for CAD.
Chelation Therapy for the ischemic Heart
Disease: A randomized controlled Trial
Division of Cardiology, University of Calgary and
Calgary Regional Health Authority, Calgary,
Alberta, Canada.
(2000) 287:4
• Objective: was to discern whether or not
EDTA chelation therapy had a positive impact on
an individual’s ability to exercise due to their
ischemic heart, as well as measure their quality
of life.
• Study Design: Double-blind, placebo
controlled
• Subjects: 84 people, M/F, 21+, stable CAD
and ability to walk on treadmill
Chelation Therapy for the ischemic Heart
Disease: A randomized controlled Trial
Division of Cardiology, University of Calgary and
Calgary Regional Health Authority, Calgary,
Alberta, Canada.
(2000) 287:4
Treatment Types:
• EDTA Chelation Therapy
• Placebo 9% solution of NaCl
Outcome measures:
• Exercise capacity on treadmill
• Exercise time to ischemia
• Quality of life measures
Chelation Therapy for the ischemic Heart
Disease: A randomized controlled Trial
Division of Cardiology, University of Calgary and
Calgary Regional Health Authority, Calgary,
Alberta, Canada.
(2000) 287:4
Results of study:
• Similar results with both sets of
participants
• No evidence to support the usage of
chelation therapy on patients with
CAD
Trial to Assess Chelation Therapy (TACT)
National Center for Complementary and
Alternative Medicine, National Institute of Health
Bethesda, Maryland, United States of America
(2002-2007)
Objective: To test the efficacy of Chelation
Therapy on CAD patients
Study Design: Double-blind, Placebo
controlled, multi-centered
Subjects: TACT is the largest trial to test the
efficacy of Chelation Therapy
- 2372 participants
- Must be receiving traditional treatment for CAD
Trial to Assess Chelation Therapy (TACT)
National Center for Complementary and
Alternative Medicine, National Institute of Health
Bethesda, Maryland, United States of America
(2002-2007)
• Treatment:
-EDTA Chelation therapy or
-Placebo solution
- All patients will receive a vitamin supplement
• Treatment regimen:
-one a week for 30 weeks
-after initial 30 treatments patients will have 10
more treatments, 2 weeks to 10 weeks apart
-treatments last for 3 hours
-Patients must continue standard heart
treatments provided by individual physician
Trial to Assess Chelation Therapy (TACT)
National Center for Complementary and
Alternative Medicine, National Institute of Health
Bethesda, Maryland, United States of America
(2002-2007)
• Result of study:
This study is currently be done! There
aren’t any results yet!
• NIH and NCCAM: Hope to provide
some evidence on the efficacy of
chelation therapy, because this is the
largest study ever done on chelation
therapy.
Does it work?
• What’s your opinion?
Conclusion
• Chelation therapy has been used as a
successful treatment for toxicities with
minerals lead, magnesium, zinc, calcium
and iron.
• Calcium is a major component of plaque
that causes CAD.
• At this time it is difficult to find reasonable
cause to support or deny the efficacy of
chelation therapy on CAD.
References
Knudtson, ML., et al., Chelation Therapy for Ischemic Heart Disease:
A randomized Controlled Trial. JAMA, 2002; 287, 4; 481-486.
http://proquest.umi.com/
Retrieved: 7/5/06
Mahan, L K., Escott-Stump, S. Krause’s Food Nutrition and Diet Therapy,
11th ed. Philidelphia: Saunders, 2004.
Nash, RA., Metals in Medicine. Alternative Therapies in Health and Medicine,
2005;11, 4; 18-26.
http://proquest.umi.com/
Retrieved: 6/26/06
National Center for Complementary and Alternative Medicine, National Institute
of Health. Learn More About Chelation Therapy and the Study, 2006.
http://nccam.nih/gov/chelation/chelationstudy.htm
Retrieved: 6/23/06
Shrihari, JS, et al., Role of EDTA chelation therapy in cardiovascular diseases.
The National Medical Journal of India, 2006;19.
http://www.nmji/archives
Retrieved: 7/5/06
Chelation Therapy
The End!